BRADLEY RANDALL CONGLETON DMD
NPI 1952754749
Dentist - Dental Public Health in Louisville, KY

Q: What is Bradley Congleton's NPI number?

The NPI number for Bradley Congleton is 1952754749. It was assigned to this individual provider in the NPPES registry on July 18, 2016.

Q: What is Bradley Congleton's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Dental Public Health, with taxonomy code 1223D0001X.

Q: When was this NPI record last updated?

The NPPES record for Bradley Congleton was last updated on November 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 18, 2016PECOS Enrolled

2215 PORTLAND AVE, LOUISVILLE, KY 40212(502) 774-8631(502) 996-8309 Get Directions Write a Review

NPPES record last updated: November 18, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Nov 18, 2024, Apr 10, 2024, Dec 5, 2019 and 1 more (4 updates tracked since 2018).

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About Bradley Randall Congleton Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BRADLEY RANDALL CONGLETON DMD (NPI 1952754749) is an individual dental public health provider in Louisville, Kentucky, licensed in Kentucky (9824) and active in the NPI registry since July 2016. He is enrolled in Medicare PECOS and maintains a secondary practice location in Catlettsburg.

NPPES Registry Identity

NPI1952754749

Entity TypeIndividualMale

Primary Taxonomy1223D0001X

Provider Legal NameBRADLEY RANDALL CONGLETONCredential: DMD

Location Address2215 PORTLAND AVELouisville, KY 40212-1033

Mailing AddressPo Box 950244Louisville, KY 40295-0244 · (502) 772-8160 · Fax (502) 772-8108

Phone(502) 774-8631

Fax(502) 996-8309

Sole ProprietorNo

Enumeration DateJuly 18, 2016

Last NPPES UpdateNovember 18, 20244 updates tracked since enumeration

NPPES CertifiedNovember 18, 2024

✔ NPI 1952754749 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · Dental Public HealthDental Providers

Taxonomy Code1223D0001X

License✔ Licensed in KY · 9824

Definition

The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.

Also ListedDentistTaxonomy 122300000X · License 12014346A (IN)

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 9824 (KY)

2215 PORTLAND AVE, Louisville, KY 40212

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Secondary Practice Location 1

Location 116005 US Route 23Catlettsburg, KY 41129-9070 · Phone (606) 739-0403

Other Identifiers 1

Medicaid7100435410KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bradley Randall Congleton Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Bradley Congleton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Health Centers, Inc.

Same address

Federally Qualified Health Center (FQHC)

2215 PORTLAND AVE
Louisville, KY 40212

Reassigned Medicare billing, Kentucky enrollment
69 clinicians in this Medicare group

NPI 1518963230 (502) 774-8631

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40212 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAIVANTI LOHANO MD

Family Medicine